Society for Translational Medicine consensus on postoperative management of EGFR-mutant lung cancer (2019 edition)

Wenhua Liang, Kaican Cai, Chun Chen, Haiquan Chen, Wentao Fang, Junke Fu, Xiangning Fu, Shugeng Gao, Jian Hu, Yunchao Huang, Ganning Jiang, Wenjie Jiao, Shanqing Li, Gaofeng Li, Hecheng Li, Hui Li, Xiaofei Li, Naixin Liang, Deruo Liu, Hongxu Liu, Jun Liu, Lunxu Liu, Yang Liu, Qingquan Luo, Haitao Ma, Weimin Mao, Zhongmin Peng, Guibin Qiao, Guoguang Shao, Lijie Tan, Qunyou Tan, Qun Wang, Changli Wang, Qingchen Wu, Shidong Xu, Songtao Xu, Lin Xu, Yue Yang, Fenglei Yu, Baijiang Zhang, Lanjun Zhang, Bo Zhao, Xiuyi Zhi, Alessandro Brunelli, René Horsleben Petersen, Chia-Chuan Liu, Biagio Ricciuti, Giulio Metro, Alessandro Tuzi, Matteo B. Suter, Matthew Evison, Nobuhiko Seki, Shinji Sasada, Takhiro Izumo, William Chi-Shing Cho, Jianxing He, written on behalf of National Clinical Research Center for Respiratory Disease, Thoracic Surgery Branch of China International Exchange and Promotion Association for Medical and Healthcare, Chinese Alliance Against Lung Cancer and AME Thoracic Surgery Collaborative Group

Abstract

Non-small cell lung cancer (NSCLC) is the most common and fatal tumor worldwide, with 2.1 million new cases and 1.77 million deaths per year (1). With the wider application of examination approaches and the improvement of health awareness, higher proportions of surgically resectable early and mid-stage lung cancers have been detected. In overall, only 50% of patients have been cured after radical resection. In other cases, however, NSCLC is highly active and recurrence and/or metastasis can easily occur after surgery. In these patients, systemic therapy as a postoperative adjuvant therapy is required to eliminate or reduce residual micro-lesions to lower the risk of recurrence; meanwhile, the patients should be closely monitored to detect early recurrence. EGFR mutation is a major mutation type in lung cancer, and is seen in about 40% of lung cancer cases in Asia (2). Compared with wild types and other mutation types, EGFR-mutant NSCLC has its unique biological properties and drug susceptibilities, and thus requires specific diagnosis and treatment strategies. This expert consensus aims to review the current evidence and provide recommendations on key issues.